Clinicopathological Predictors of Recurrence in High-Risk Basal Cell Carcinoma Patients, A Retrospective Analysis

ObjectiveThis study aimed to identify key prognostic factors for recurrence and disease-free survival in high-risk basal cell carcinoma (BCC) patients, focusing on tumor budding, tumor-infiltrating lymphocytes, and adjuvant radiotherapy.MethodsIn this 5-year retrospective cohort study, 34 patients with high-risk nodular BCC who underwent complete surgical excision were evaluated. Clinicopathological data, including tumor budding and tumor-infiltrating lymphocytes scores, were analyzed. Patients were categorized by recurrence status, and factors influencing recurrence and disease-free survival were assessed using odds ratios with 95% confidence intervals.ResultsThe median age was 63 years (range: 48-82), with 77% men. Tumor budding was detected in 16 patients and was significantly associated with recurrence (odds ratio 3.6, 95% confidence intervals: 1.2-6.8). Low tumor-infiltrating lymphocytes scores (score 1) were also linked to recurrence (odds ratio 4.5, 95% confidence intervals: 1.6-8.2). Patients who did not receive adjuvant radiotherapy had a higher risk of recurrence (odds ratio 5.2, 95% confidence intervals: 2.0-9.1). The 5-year disease-free survival was 47% overall, 80.0% in patients who received radiotherapy, and 0.0% in those who did not.ConclusionTumor budding and low tumor-infiltrating lymphocytes scores are strong predictors of recurrence and poor disease-free survival in high-risk basal cell carcinoma. Adjuvant radiotherapy significantly improves outcomes in advanced-stage patients. These markers may support individualized treatment planning and the use of adjuvant radiotherapy in high-risk settings.